Penny*, just in her early twenties, is already a survivor of sexual abuse by a family member. “I was angry and bewildered about life and why I had to live these experiences…I just didn’t know how to deal with it,” she says.
Penny became suicidal and was treated for post-traumatic stress disorder stemming from the abuse she suffered. While in treatment, she dropped out of school and left her home to live with friends. Penny’s risk of becoming homeless caused a member of her treatment team to suggest, and help her apply for, the Transitional Age Youth Crossroads Program. Since entering the program, Penny says, “My life has changed radically.”
The Crossroads Program is funded by the voter approved Mental Health Services Act (MHSA), or Proposition 63. Crossroads is a unique and strategic program focusing on recovery, resiliency and wellness principles targeted toward transitional age youth (TAY) ages 18-25, who have been diagnosed with a mental illness. Like Penny, many of these youth have been left out in the cold when it comes to developing adult skill sets like budgeting, how to interview for a job, accessing options for higher education, banking, using public transportation and adopting adult behaviors. Crossroads seeks to meet the need for an adult skill set while preparing TAY for living within a community setting.
Prior to the passage of Prop 63, although there were programs for children and adults with mental illness, there was a wide gap in services for TAY. With no access to assistance, these young adults run a high risk for homelessness and psychiatric hospitalization. The Prop 63-funded TAY Crossroads Program now stands in that gap by providing a place where needed mental health services and residential support services co-exist. “MHSA has empowered mental health agencies to address serious mental illness issues with a focus on prevention and early intervention, partnered with supportive medical care,” says Tulare County Chairman of the Board of Supervisors and Mental Health Board Member Pete Vander Poel. “The impact of MHSA on service programs means a positive progression towards a healthier community.” Penny says the TAY program, “gave me a new family and helped build me into an independent woman who likes herself.”
The TAY Crossroads Program is administered by MHSA contractor EMQ Families First and focuses on “decreasing risk factors while increasing proactive behaviors,” says Christi Lupkes, MHSA Manager with the Tulare County Health & Human Services Agency. “While the TAY are recovering, they’re developing adult skill sets and life-planning tools.” Under this model of wellness and recovery, medical or pharmaceutical support and the identification and development of goals are undertaken simultaneously, once a diagnosis of mental illness has been made. The paradigm is shifted from “an illness-centered treatment to a person-centered model,” explains Lupkes.
This shift to a person-centered model is challenging at times, as it involves changes to traditional methods and core ideas about treating the mentally ill, including careful attention to cultural competency and the inclusion of the voices of the client and client’s family members in developing the treatment plan. The concept follows the broad mission of the MHSA, which incorporates strengthening community services and supports for those with chronic and persistent mental illness; prevention and early intervention models to catch mental illnesses before they become severe; increasing the mental health workforce; more locations for provision of services; technology to manage a complicated system; and the development of novel ideas or practices that have the potential for being adopted by mental health programs.
The success of the Crossroads program is notable. To date, a total of 133 TAY have received housing and supportive services through the program (21 in FY 08/09; 35 in 09/10; 41 in 10/11; and 36 in 11/12). Since the inception of the program, approximately 85 percent of TAY who have completed Crossroads have received a GED or are pursuing continuing education. In 2012 alone, this education rate increased to 88 percent. Importantly, involvement in the Crossroads program greatly reduces the rate of psychiatric hospitalization. For the total TAY population being served at Crossroads, 71 percent maintained zero hospitalizations and 21 percent saw a reduction. Moreover, approximately 60 percent of TAY have transitioned to living independently (alone or with a roommate), while 20 percent live with biological or adoptive parents, and 10 percent live with a relative. For the TAY, that step of integration into the community is the end goal of the Crossroads program.
The two-year Crossroads program puts TAY on a rapid pace toward that end goal. The major focus in the first year is learning to trust and work with mental and residential health support teams, along with building relationships. TAY have to be up by 9 a.m., go to school, keep their regular therapist appointments, clean their apartments and be properly dressed in the morning – a structure many TAY have no experience with. The second year of the Crossroads program builds on the first year’s knowledge by adding employment, house or apartment hunting, and practical life skills. “Crossroads provides youth with many firsts in their lives, such as structure and rules that are administered with caring and compassion. They learn skills to assist them with their future independence and ongoing recovery. The youth become a community in the true sense of the word as they support and encourage each other on a daily basis. It is remarkable to see the growth and commitment of the youth in the program,” states Timothy Durick, Psy.D., mental health director for the Tulare County Health & Human Services Agency.
Crossroads provides support groups, exercise and classes on grocery shopping and budgeting, along with learning how to schedule a day. At the Crossroads wellness and recovery centers, TAY can learn to cook, use computer labs, create art and design projects all within the scope of a wellness model. Many TAY “were neglected or experienced systems and situations in which they were not seen or treated like persons,” says Lupkes. “At some point during the two-year program, TAY begin to realize they can manage living within a community setting.”
Penny says she was upset at first by having to adhere to the TAY program schedule and could not understand the structure she was asked to abide by. She also says it was a difficult transition, but she started to attend peer meetings and soon became involved with a local community group for women and girls, which led to her participation in the ACT Female Leadership Academy.
“When they get here they think this is ‘just another program,’” notes one Crossroads staff member. “But the young people find that we measure success in a different way and that they are treated with respect and dignity. We’re there to support and mentor them like a real family should. We believe in them, and we praise them.” Penny says that, “the program mentors spoke in positive terms about who I am right now and who I could become, and I began to trust them. I began to gain hope that I could do the things that my mentors talked about…like doing well in school, and becoming a leader for other girls who had experiences like mine.”
Penny’s success story has just begun. She has received her high school diploma and has begun a community college program for an AA degree. Penny has also graduated from a local women’s leadership academy and has been awarded an internship as an advocate for LGBTQ and immigration issues. She recently obtained her driver’s license and now helps out with volunteer coordination for the TAY program. This courageous survivor smiles proudly and confidently as she talks about her young son whom, she notes, she has taken care of independently.
Though Penny was the beneficiary of the MHSA-funded Crossroads program, her son is also benefiting. Penny has chosen to take parenting classes and volunteers with her son’s t-ball team. Penny is confident that if she had not participated in the Crossroads program, she would not be where she is today. “I have my goals, I’ve learned to be independent, and I really like who I am,” says Penny. “My diagnosis has not defined me.”
*Name and details have been altered to protect privacy.